National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 903178

History of Changes from the VAERS Wayback Machine

First Appeared on 12/18/2020

VAERS ID: 903178
VAERS Form:2
Age:29.0
Sex:Female
Location:Florida
Vaccinated:2020-12-17
Onset:2020-12-17
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest discomfort, Dizziness, Erythema, Injection site pruritus, Pruritus, Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Answered Yes to question 7: Do you take cortisone, prednisone, other steroids, or anticancer drugs or have had radiation treatments. Followed Protocol, developed by Occupational Health. O.K. to proceed by BSN COHN-S
Current Illness: No
Preexisting Conditions: Yes, asthma Followed Protocol, developed by Occupational Health. O.K. to proceed by BSN COHN-S
Allergies: No
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Two minutes after vaccination, she reported itching at the site. Upon assessment, red hives started to develop. Dr. came and assessed patient. Benadryl 50 mg. PO and 2 puffs Albuterol administered by Rapid Response Team RN. Tightness in chest, lightheaded, lungs clear throughout, itchiness in left arm. Resolved within 15 minutes.


Changed on 12/24/2020

VAERS ID: 903178 Before After
VAERS Form:2
Age:29.0
Sex:Female
Location:Florida
Vaccinated:2020-12-17
Onset:2020-12-17
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest discomfort, Dizziness, Erythema, Injection site pruritus, Pruritus, Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Answered Yes to question 7: Do you take cortisone, prednisone, other steroids, or anticancer drugs or have had radiation treatments. Followed Protocol, developed by Occupational Health. O.K. to proceed by BSN COHN-S
Current Illness: No
Preexisting Conditions: Yes, asthma Followed Protocol, developed by Occupational Health. O.K. to proceed by BSN COHN-S
Allergies: No No
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Two minutes after vaccination, she reported itching at the site. Upon assessment, red hives started to develop. Dr. came and assessed patient. Benadryl 50 mg. PO and 2 puffs Albuterol administered by Rapid Response Team RN. Tightness in chest, lightheaded, lungs clear throughout, itchiness in left arm. Resolved within 15 minutes.


Changed on 12/30/2020

VAERS ID: 903178 Before After
VAERS Form:2
Age:29.0
Sex:Female
Location:Florida
Vaccinated:2020-12-17
Onset:2020-12-17
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest discomfort, Dizziness, Erythema, Injection site pruritus, Pruritus, Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Answered Yes to question 7: Do you take cortisone, prednisone, other steroids, or anticancer drugs or have had radiation treatments. Followed Protocol, developed by Occupational Health. O.K. to proceed by BSN COHN-S
Current Illness: No
Preexisting Conditions: Yes, asthma Followed Protocol, developed by Occupational Health. O.K. to proceed by BSN COHN-S
Allergies: No No
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Two minutes after vaccination, she reported itching at the site. Upon assessment, red hives started to develop. Dr. came and assessed patient. Benadryl 50 mg. PO and 2 puffs Albuterol administered by Rapid Response Team RN. Tightness in chest, lightheaded, lungs clear throughout, itchiness in left arm. Resolved within 15 minutes.

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=903178&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166